Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).

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Old 11-20-2011, 07:30 PM #1
greenfrog greenfrog is offline
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Mark, what I meant was that I understand Crosby has been exerting himself 100% in practice without subjectively experiencing any symptoms. The reports from his practice sessions are reportedly very positive.

Further, I believe that Collins and Carrick are being ultra-cautious with Crosby (their reputations are on the line, for one thing). I do not believe they would be clearing him to play had he reported experiencing *any* symptoms in recent weeks. I imagine that Crosby has been consulting medical doctors as well, though probably not the Penguins doctors that idiotically cleared him to play almost immediately after his first concussion in January.

However, I am not saying that I believe Crosby's brain is fully recovered, that he has the same resilience as before, or that he will be able to play at 100% of his former ability. All of this remains to be seen. The evidence certainly suggests that he is now at greater risk of injury from a further concussion (and possibly sub-concussive impacts).

Patrice Bergeron comes to mind as one hockey player who was out for a lengthy period with a concussion (almost a year, I believe) and is back in action playing at a high level. Other athletes have tried to come back from lengthy concussions but have encountered difficulties, and some have had to retire (eg, Corey Koskie, Mike Matheny, Paul Kariya).
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Old 11-20-2011, 09:47 PM #2
rick92 rick92 is offline
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i definitely respect his decision to continue playing. you only live once so might as well try to enjoy it. also with that being said, he is taking a big risk, but he is obviously aware of the risk because im sure he has suffered a whole lot this past year and knows what its like to have pcs. if he can stay symptom free and not have any more concussions then its a good decision for him, thats probably hard to do in the NHL though

just my 2 cents.
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Old 11-20-2011, 10:13 PM #3
Mark in Idaho Mark in Idaho is offline
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The problem Crosby faces is not getting another concussion. It is sustaining sub-concussive impacts. He will suffer many sub-concussive impacts in each game once he returns to the ice. His ability to skate at 100% intensity or effort has little to do with his ability to return to the game.

As Collins has stated directly, his Buffalo protocol only prepare the athlete to return to the game "physical symptom free." The iMPACT test only tests at a surface level. Even a full Neuro-Psych Assessment battery falls short of giving adequate information.

I doubt Crosby has any medical doctors overseeing his condition "who have a reasonable understanding of how to test him for return to play condition." There are no standard tests for use by any professional that fully test for recovery condition.

I suggest that Crosby has been released to return to play based on a few criteria.
1. He is no longer experiencing head aches, even during or after physical exertion.
2. He has regained his vestibular functions to an acceptable level.
3. He has regained his reaction times to an acceptable level.
4. He has regained an acceptable level of his baseline cognitive skills.

What he has likely not been tested for are:
1. His reaction times when he is at the end of his on-ice shift.
2. His judgment skills when he is at the end of his on-ice shift.
3. His cognitive skills when he is at the end of his on-ice shift.
4. The above when he is oxygen deprived due the cumulative effect of exertion from a period of play.
5. The above (1-3) when his blood/body is flush with the waste from muscle efforts and the related pounding of play.

So, I would hope that he can keep track of how he feels and how he is thinking and is willing to pull himself from the game if he notices any deterioration of 1-3 skills above. Unfortunately, a deterioration of judgment skills often prevents making sound judgments to end play.

The days and weeks after returning to aggressive play will tell.
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Old 11-21-2011, 10:03 PM #4
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Default Crosby's spectacular return

Crosby scored two goals and two assists in his return tonight. He looked very, very happy. Let's keep our fingers crossed for Sid the Kid.

http://www.nytimes.com/2011/11/22/sp...tml?ref=sports
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Old 11-21-2011, 10:06 PM #5
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Here's the game recap:

http://sports.espn.go.com/nhl/recap?gameId=400047520
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